Cultura

Prevalence And Epidemiological Characteristics Of Healthcare-Associated Methicillin-Resistant Staphylococcus Aureus (MRSA) In Primary Healthcare Centers In The Kingdom Of Saudi Arabia A Narrative Literature-Based Analysis Of Published National Evidence

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Faisal M. A. Alzahrani, Faisal A. Alzahrani, Adnan A. Alzahrani, Abdullah A. S. Alzahrani, Ghazi A. H. Alalawy, Marwan S. J. Mouawad,Torki S. S. Alharthi, Fahad H. Al-Lahaibi, Ahmad A. Alheaby,Faisal A. Alotaibi, Mohanna R. Al-Rogi,Abdulwahab S. Alzahrani

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) continues to be a major cause of infections linked to healthcare settings and presents a serious threat to patient safety and infection prevention. The frequency and epidemiological features of healthcare-associated MRSA are described in this paper by synthesizing available data from the Kingdom of Saudi Arabia, with special attention on basic healthcare facilities. With pooled estimates ranging from roughly 8.6% to 17.0%, national systematic reviews and meta-analyses revealed significant variation in MRSA prevalence across healthcare settings, with greater rates recorded in specific geographic locations and clinical contexts. A possible reservoir for transmission at the community–healthcare interface was indicated by evidence from outpatient and primary healthcare settings that showed significant MRSA colonization, including a reported nasal carriage rate of 25% among primary healthcare center attendance. Significant MRSA carriage was found in studies involving healthcare personnel, underscoring their part in promoting the virus's transmission within medical institutions. Additionally, hospital-based surveillance data revealed rising MRSA trends over time, especially among patients with chronic comorbidities and in surgical wards. When taken as a whole, the results highlight the fact that MRSA is relevant in primary healthcare settings as well as hospitals. To lessen MRSA transmission and aid in national antibiotic resistance management initiatives, these findings highlight the necessity of improved infection prevention and control protocols, consistent surveillance, and focused interventions in primary healthcare facilities.

Keywords : .
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty